Provider Demographics
NPI:1033791264
Name:BROWN, LAKEESHA (MS, LPCIT)
Entity Type:Individual
Prefix:
First Name:LAKEESHA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS, LPCIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2530
Mailing Address - Country:US
Mailing Address - Phone:414-455-3879
Mailing Address - Fax:866-719-3024
Practice Address - Street 1:1138 W GARFIELD AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205-1324
Practice Address - Country:US
Practice Address - Phone:262-777-1435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WI4937-226101Y00000X
WI10953-125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor